Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/68436
Title: Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration
Author: Duda, Stephany N.
Farr, Amanda M.
Lindegren, Mary Lou
Blevins, Meridith
Wester, C. William
Wools-Kaloustian, Kara
Ekouevi, Didier K.
Egger, Matthias
Hemingway-Foday, Jennifer
Cooper, David A.
Moore, Richard D.
McGowan, Catherine C.
Nash, Denis
International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration
Keywords: Sida
Malalts de sida
Nutrició
Antiretrovirals
AIDS (Disease)
AIDS patients
Nutrition
Antiretroviral agents
Issue Date: 15-Dec-2014
Publisher: International AIDS Society
Abstract: INTRODUCTION: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. METHODS: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. RESULTS: Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. CONCLUSIONS: This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.
Note: Reproducció del document publicat a: http://dx.doi.org/10.7448/IAS.17.1.19045
It is part of: Journal of the International AIDS Society, 2014, num. 17, p. 19045
Related resource: http://dx.doi.org/10.7448/IAS.17.1.19045
URI: http://hdl.handle.net/2445/68436
ISSN: 1758-2652
Appears in Collections:Articles publicats en revistes (ISGlobal)

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